- The Cigna Group (St. Louis, MO)
- …or 3+ years of equivalent work experience + Relevant experience as a Fraud Investigator in healthcare + Certified Pharmacy Technician, Certified Fraud ... and Abuse activities. Interactions will include meetings with attendees including partner Senior Managers and Directors. + Coordinate multiple investigations to… more
- Humana (Indianapolis, IN)
- **Become a part of our caring community and help us put health first** This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity ... (OMPP PI) and other agencies such as the Medicaid Fraud Control Unit (MFCU) and coordinate all...Bachelor's degree + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge… more
- CareFirst (Columbia, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Special Investigations Unit ( SIU ) Investigator , Sr . is to assist in the reduction and ... timely, effective and result in an overall achievement of unit goals. + Investigator , Sr ....assigned by management to meet the needs of the Special Investigations Unit . **QUALIFICATIONS:** **Education… more
- USAA (San Antonio, TX)
- …of 10 consecutive business days each calendar year. As a dedicated with **Director, Special Investigations Unit ( SIU ),** you will be responsible ... fraud investigation programs and management of the Life Special Investigation Unit ( SIU ) staff....broad understanding of procedures related to SIU investigations . + Knowledge and experience in fraud … more
- CVS Health (Wellesley, MA)
- …make health care more personal, convenient and affordable. **Position Summary** The Special Investigations Unit is seeking a Sr . Manager to lead our new ... ASO investigations team. The Healthcare Fraud Senior Manager is responsible for overseeing...(eg, Certified Fraud Examiner (CFE), accredited healthcare fraud investigator (AHFI) **Education:** + Bachelor's degree… more
- USAA (Atlanta, GA)
- …+ Leads high exposure, high profile and critical work assignments, and special investigations involving sophisticated niche fraud referrals, (examples: ... so special ! **The Opportunity** As a dedicated SIU field investigator , within defined guidelines and...our members from potential fraudulent claims by investigating complex fraud investigations with significant financial impact to… more
- Fallon Health (Worcester, MA)
- …is a plus, such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), or other coding certifications or similar in the ... clinical background. + Strong attention to detail with the ability to identify fraud , assess the impact, resolve investigations , mitigate risk, and capture… more
- CVS Health (Hartford, CT)
- …care more personal, convenient and affordable. **Position Summary:** As a Senior Investigator you will conduct high level, complex investigations of known or ... Bachelor's degree or an additional 5 years of working health care fraud , waste and abuse investigations . **Pay Range** The typical pay range for this role is:… more
- CVS Health (Raleigh, NC)
- …high level, complex investigations of known or suspected acts of healthcare fraud , waste and abuse. + Conduct Investigations to prevent payment of suspect ... Facilitates the recovery of company and customer money lost as a result of fraud , waste and abuse. + Cooperates with federal, state, and local law enforcement… more